Provider Demographics
NPI:1891270385
Name:BARNES, JONATHAN DAVID (PA-C)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:DAVID
Last Name:BARNES
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:31565 RANCHO PUEBLO RD STE 201
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-4839
Mailing Address - Country:US
Mailing Address - Phone:951-544-5340
Mailing Address - Fax:
Practice Address - Street 1:31565 RANCHO PUEBLO RD STE 201
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92592-4839
Practice Address - Country:US
Practice Address - Phone:951-225-7800
Practice Address - Fax:951-225-7818
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2021-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA56056363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant